2. ANATOMY OF THE FEMALE REPRODUCTIVE SYSTEM
Mona Ahmed El-Safadi

3. OBJECTIVES At the end of the lecture, students should:
List the organs of female reproductive system.
Describe the pelvic peritoneum in female.
Describe the position and relations of the ovaries.
List the parts of the uterine tube.
Describe the anatomy of uterus regarding: subdivisions, cavity, relations, ligaments & main support.
Describe the anatomy of vagina regarding: structure, extent, length & relations.
Describe the supply (arteries, veins, lymph, nerves) of female reproductive system.

4. FEMALE REPRODUCTIVE SYSTEM
UTERINE TUBE
OVARY
UTERUS V A G I N
POSTERIOR VIEW

5. PELVIC PERITONEUM IN FEMALE
BROAD
LIGAMENT
Rectouterine (Douglas) pouch: Reflection of peritoneum from rectum to upper part of posterior surface of vagina
Uterovesical (vesicouterine) pouch: Reflection of peritoneum from uterus to upper surface of urinary bladder
Broad ligament of uterus: Extension of peritoneum from lateral wall of uterus to lateral wall of pelvis, encloses the uterine tubes

6. PELVIC PERITONEUM IN FEMALE

7. THE OVARIES It is an almond-shaped organ.
BROAD
LIGAMENT
Female pelvic organs
(Posterior view)
It is an almond-shaped organ.
It is attached to the back of the broad ligament by a peritoneal fold (mesovarium)
Its medial end is attached to uterus by ligament of ovary.
Its lateral end is related to the fimbriae of the uterine tube.

8. THE UTERINE (FALLOPIAN) TUBES
It is 10 cm long.
It is enclosed in the broad ligament of uterus.
It is divided into:
1) Intramural part: opening into the uterine wall
2) Isthmus: narrowest part
3) Ampulla: widest part (site of fertilization)
4) Infundibulum: funnel-shaped end, has finger-like processes (fimbriae), related to ovary
THE UTERINE (FALLOPIAN) TUBES 2 3 1 4 X

9. FUNCTION OF: OVARIES: PRIMARY SEX ORGANS IN FEMALE
Production of female germ cells
Secretion of female sex hormones
UTERINE TUBES:
Site of fertilization
Transport of fertilized ovum into the uterus

10. THE UTERUS 2’ 3’ A hollow, pear-shaped muscular organ 1’ Divided into:
Fundus: no cavity
Body: cavity is triangular
Cervix: cavity is fusiform, divided into:
*Supravaginal part
*Vaginal part 1’
Fundus
Body

11. THE UTERUS FUNDUS: The part of uterus above the level of uterine tubes
BODY: The part of uterus from the level of uterine tube to the level of the isthmus
of uterus
CERVIX: The part of the uterus below the level of the isthmus of the uterus

12. THE CERVICAL CANAL
Multiparous
Nulliparous
INTERNAL OS: opening between cavity of body of uterus & cavity of cervix (cervical canal)
EXTERNAL OS: opening between cervical canal & cavity of vagina
In a nulliparous woman: external os appears circular.
In a multiparous woman: external os appears as a transverse slit with an anterior & a posterior lip.

13. RELATIONS OF UTERUS FUNDUS + BODY + SUPRAVAGINAL PART OF CERVIX:
Anterior: superior surface of urinary bladder
Posterior: sigmoid colon
Lateral: uterine artery
VAGINAL PART OF CERVIX: surrounded by vaginal fornices
Anterior: anterior fornix of vagina
Posterior: posterior fornix of vagina
Lateral: lateral fornices of vagina

14. FUNCTION OF UTERUS

15. Long axis of whole uterus is bent forward on long axis of vagina
POSITIONS OF UTERUS
ANTEVERTED UTERUS
ANTEFLEXED UTERUS
Long axis of whole uterus is bent
forward on long axis of vagina
Long axis of body of uterus is bent
forward on long axis of cervix

16. POSITIONS OF UTERUS RETROVERTED UTERUS RETROFLEXED UTERUS
Fundus & body of uterus are bent backward
on the vagina and lie in rectouterine pouch
Long axis of body of uterus is bent
backward on long axis of cervix

17. USUAL POSITION OF UTERUS
ANTEVERTED ANTEFLEXED UTERUS

18. (At the level of uterine tube)
LIGAMENTS OF UTERUS
1)Ligaments at junction between fundus & body of uterus
(At the level of uterine tube) 2
Extends through inguinal canal
to labium majus 1

19. LIGAMENTS OF UTERUS 2)Ligaments of cervix pelvic walls
Extend from cervix to: anterior (pubocervical),
lateral (transverse cervical or cardinal)
posterior (uterosacral or sacrocervical)
pelvic walls

20. LEVATOR ANI MUSCLES
FORM THE PELVIC FLOOR: separate pelvis from perineum
FORM PELVIC DIAPHRAGM: traversed by urethra, vagina & rectum
SUPPORT PELVIC ORGANS
Urethra
Levator ani
Vagina
Urethra
Rectum
Rectum
Vagina

21. SUPPORT OF UTERUS UTERINE PROLAPSE
Round ligament of uterus (maintains anteverted anteflexed position)
Ligaments of cervix (especially transverse cervical)
Levator ani muscles
UTERINE PROLAPSE
Downward dispalcement of uterus due to damage of:
Ligaments of uterus
Levator ani muscles

22. VAGINA STRUCTURE: Fibro-muscular tube
EXTENT: From external os, along pelvis & perineum, to open in the vulva (female external genitalia), behind urethral opening
LENGTH: Its anterior wall (7.5 cm) is shorter than its posterior wall (9 cm)
FUNCTION: 1) Copulatory organ & 2) Birth canal

23. RELATIONS OF VAGINA
ANTERIOR: Urinary bladder (in pelvis) & urethra (in perineum)
POSTERIOR: Rectum (in pelvis) & anal canal (in perineum)
LATERAL: ureters (in pelvis)

24. ARTERIAL SUPPLY From abdominal aorta From internal iliac artery
(Artery of pelvis)

25. ORGAN
ARTERIES
VEINS
LYMPHATICS
NERVES
(AUTONOMIC)
OVARIES
OVARIAN (ABDOMINAL AORTA)
OVARIAN (TO INFERIOR VENA CAVA & LEFT RENAL VEIN)
TO PARAAORTIC LYMPH NODES (IN ABDOMEN)
OVARIAN PLEXUS (IN ABDOMEN)
UTERINE TUBES
OVARIAN
UTERINE
PARAAORTIC
INTERNAL ILIAC
INFERIOR HYPOGASTRIC
UTERUS
UTERINE (INTERNAL ILIAC ARTERY IN PELVIS)
UTERINE PLEXUS (TO INTERNAL ILIAC VEIN)
TO INTERNAL ILIAC LYMPH NODES (IN PELVIS)
INFERIOR HYPOGASTRIC PLEXUS (IN PELVIS)
VAGINA
VAGINAL (INTERNAL ILIAC ARTERY IN PELVIS)
VAGINAL PLEXUS (TO INTERNAL ILIAC VEIN

26. QUESTION 1
Regarding the female reproductive organs, which one of the following statement is correct?
The ampulla is the most medial part of the uterine tube.
The rectum is anterior to the vagina.
The ovarian artery is a branch of the internal iliac artery of the pelvis.
The uterine tube is enclosed in the broad ligament of the uterus.

27. QUESTION 2
Which one of the following structures is related (or attached) to the lateral end of the ovary?
Fimbriae of uterine tube
Ampulla of uterine tube
Ligament of ovary
Round ligament of uterus

28. QUESTION 3
Which one of the following structures is anterior to the uterus?
Urinary bladder
Ureter
Sigmoid colon
Ovary